CFO Details Positive Impact of Leveraging Revenue Cycle Technology

Todd Mallon, Advocare’s CFO, says the organization has a near-perfect net collections ratio.

Improving net collections rates and overall revenue cycle management processes is paramount to revenue cycle leaders, and adding new solutions and automation to streamline these operations has been a must for many organizations.

Todd Mallon, CFO to callOne of Pennsylvania and New Jersey’s largest independent physician-owned and physician-led multi-specialty medical organizations recently spoke with HealthLeaders about applying new technologies to streamline the healthcare system’s revenue cycle management operations.

With more than 650 providers and 3,000 staff at more than 150 independent care centers facilitating nearly two million patient visits per year, Mallon said simplifying the revenue cycle is essential.

Since Advocare has implemented new technology from eClinicalWorks to assist its revenue cycle management operations, it now has a 99% net collection rate. As the industry standard rate for net collections is 95%, Advocare is currently operating well above average and is experiencing positive effects of this change across all care centres.

“I spend a lot less time discussing processes and denials with our accounts receivable teams. We now have enough room and flexibility to focus on expanding our operations and meeting the needs of more patients in our community,” Mallon says.

HealthLeaders: What types of issues were you seeing that made you realize you needed to implement a change in your revenue cycle? What was your main driver?

Todd Mallon: Our net collections ratio was the strongest indicator we needed to change our revenue cycle management solution. The net collection rate measures how effectively our app collects reimbursement for services from patients and payers. This metric has always been the most important determinant of financial success in healthcare organizations.

However, with our previous application management system, our net collection rate was constantly falling. I felt like I spent most of my time at each financial review meeting discussing accounts receivable, disapprovals, and current processes to get to the heart of this matter. This meant that our teams spent most of their time correcting day-to-day operations that were limiting our ability to grow and provide high-quality care to more patients. Therefore, our main driving force in changing our revenue cycle management was to equip our finance and receivables teams with the support and resources they need to improve our net collections ratio.

HealthLeaders: What was the process of implementing the new technology and who was involved in the decision-making process in your organization?

mallon: Everyone on our leadership team supported the decision-making process. We wanted all stakeholders to be represented in the decision-making process, between our CEO providing a medical perspective, the management team and myself providing a financial and operational perspective, and our task force of multiple physician leaders across all our specialties. process.

Until implementation, we had several meetings with our vendor to define specific targets, metrics and deliverables to improve our net collection rate. Training was the next step as we aligned with the core workflow and backend operations. The system was new to everyone from our CEO to providers to management, so we needed a lot of support to train our people. Without proper training, we were unlikely to see our net collection rate increase.

Prior to launch, a select group of our staff traveled to Boston for a complete overview and training of the new system. Three months before launch, our vendor’s team trained our vendors to be confident with the system. We also provided pre-launch training courses to the rest of our staff. However, even after the training, the team was available for a quick phone call or chat to answer questions or troubleshoot a potential problem with the system or workflow.

HealthLeaders: How long did it take for your organization to fully implement the technology, and how did it work since your app has spread to so many clinics?

Mallon: The system was difficult to start up and we would not have been able to implement the technology smoothly without the support of the vendor. We launched the new solution in all 150 health centers in one day. We did everything from scratch and we had to start strong.

We have eClinicalWorks trainers in each care center for approximately one week to two weeks after launch to help with the transition and train additional Advocare staff. During implementation, we trained internal staff as point people for the solution so they could continue with further implementation and staff training.

HealthLeaders: What positive results have you noticed since implementation?

mallon: The most noticeable positive result is our increased net collection rate. Several things contributed to this increase.

First, we have a dedicated eClinicalWorks team that handles our daily collections and follow-ups to ensure we receive requests on time. To create an efficient workflow, the team helped us create billing-ready rules to ensure care centers completed reports accurately. We may create alerts for missing information or incomplete requests. In addition to these in-workflow guidelines, the team reports issues to us, giving us plenty of time to gather additional information from providers or communicate next steps with payers.

Second, our supplier’s team also handles rejection appeals for our care centers. So, if a refusal comes from a particular center that needs to be addressed or changed, they help that center submit an appeal and track the progress of the claim in our system. When we receive payments, they handle cash collections and send them internally so we can track our income in real time.

HealthLeaders: What are some keys to success that you can share with another organization that wants to do the same for their facilities?

mallon: The first key to success that I will share with other organizations looking to improve their revenue cycle is knowing where you are right now. Find out your net collection rate and how many days your receivables are unpaid. Once you have a foundation, you can set goals and implement strategies to improve workflows and increase collections. And once you have these metrics, keep track of them and update them regularly. We hold regular meetings with our team to discuss our current metrics, compare them to our revenue and collections targets, and adjust our workflow and operations as needed. To be successful, especially in the revenue cycle, everything needs to be measurable.

Second, train your team on new technology. Especially for multi-site healthcare operations, it is imperative that each care center has people who can monitor the success of the solution and train new staff as needed. Now every care center works at its best. It’s also easier to open new care centers because we have a unified system.

Finally, choose a healthcare IT provider that listens to and learns from your organization. Open communication between a healthcare IT vendor and an application customer can benefit both parties. For example, based on our experience with their technology and discussions between our staff and the eClinicalWorks team, they came up with a bulk lock button that locks multiple charts simultaneously to minimize clicks and improve billing efficiency. The most valuable part of our partnerships is open communication. We are willing to learn from them and they are willing to learn from us. Thanks to this open communication, our providers and staff benefit from more efficient workflows and our net collections have increased. Through them, we are also exposed to new opportunities to improve healthcare IT solutions.

In the end, patients have a better experience and everyone wins.

Amanda Norris is the Revenue Cycle Editor for HealthLeaders.

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